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  1. StudyEvent: ACNS0122 On Study Worksheet
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Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header
Protocol ID COG
Item
COG Study Number
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1516477 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Institution Name
Item
Institution Name
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
PatientCOGIdentifierNumber
Item
COG Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C39353 (NCI Thesaurus Property-2)
C1516477 (UMLS 2011AA Property-2)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Form Completion Date
Item
Today's date
date
C19464 (NCI Thesaurus ObjectClass)
C1549507 (UMLS CUI-1)
C25250 (NCI Thesaurus Property)
C25604 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
DataEnteredDate
Item
Date worksheet entered into RDE
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C37949 (NCI Thesaurus Property)
C1521975 (UMLS 2011AA Property)
Item Group
Miscellaneous Patient Information
SpecimenAccessionNumber
Item
Accession number
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25402 (NCI Thesaurus Property)
C1510755 (UMLS 2011AA Property)
StudyStratificationText
Item
Stratum
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15206 (NCI Thesaurus ObjectClass)
C0008972 (UMLS 2011AA ObjectClass)
C25689 (NCI Thesaurus Property)
C1514983 (UMLS 2011AA Property)
Protocol Treatment Arm
Item
Assigned Treatment Arm
text
C25337 (NCI Thesaurus ValueDomain)
C1522541 (UMLS CUI-1)
C32141 (NCI Thesaurus Property)
C15368 (NCI Thesaurus ObjectClass)
TreatingInstitutionIdentifierCode
Item
Treating Institution Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25705 (NCI Thesaurus ObjectClass-2)
C1522326 (UMLS 2011AA ObjectClass-2)
TreatingPhysicianName
Item
Treating Physician
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25741 (NCI Thesaurus ObjectClass)
C0031831 (UMLS 2011AA ObjectClass)
C25705 (NCI Thesaurus ObjectClass-2)
C1522326 (UMLS 2011AA ObjectClass-2)
Item
XRT associated with this study?
text
C15313 (NCI Thesaurus ObjectClass)
C1522449 (UMLS 2011AA ObjectClass)
C25619 (NCI Thesaurus Property)
C1301732 (UMLS 2011AA Property)
CL.1
Code List
XRT associated with this study?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Conditional (Conditional)
CL024262 (NCI Metathesaurus)
PatientRegistrationDate
Item
Date of Registration
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25367 (NCI Thesaurus ValueDomain-2)
C25646 (NCI Thesaurus Property)
C1514821 (UMLS 2011AA Property)
Treatment Begin Date
Item
Treatment Start Date
date
C15368 (NCI Thesaurus ObjectClass)
C25431 (NCI Thesaurus Property)
C3173309 (UMLS CUI-1)
C25275 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
Item
Method of Payment
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25371 (NCI Thesaurus Property)
C0680264 (UMLS 2011AA Property)
CL.2
Code List
Method of Payment
CL Item
Private Insurance (Private Insurance)
CL Item
Medicare (Medicare)
C16665 (NCI Thesaurus)
C0018717 (UMLS 2011AA)
CL Item
Medicare And Private Insurance (Medicare and Private Insurance)
CL Item
Medicaid (Medicaid)
C0025071 (NCI Metathesaurus)
CL Item
Medicaid And Medicare (Medicaid and Medicare)
CL Item
Military Or Veterans Sponsored Nos (Military or Veterans Sponsored NOS)
CL Item
Military Sponsored (including Champus & Tricare) (Military sponsored (including CHAMPUS and TRICARE))
CL Item
Veterans Sponsored (Veterans sponsored)
CL Item
Self Pay (no Insurance) (Self pay (no insurance))
CL Item
No Means Of Payment (no Insurance) (No means of payment (no insurance))
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item Group
Pre-study Neurosurgeries
PriorSurgeryPerformedInd-3
Item
Was surgery performed prior to study enrollment?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
PriorSurgeryPerformedCount
Item
how many? [pre-study neurosurgeries) (If yes,)
float
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C15329 (NCI Thesaurus ObjectClass)
C0543467 (UMLS 2011AA ObjectClass)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Pre-treatment Imaging Studies
Item
Type [imaging studies]
text
C25284 (NCI Thesaurus ValueDomain)
C2911685 (UMLS CUI-1)
C20989 (NCI Thesaurus ObjectClass)
C16847 (NCI Thesaurus Property)
CL.4
Code List
Type [imaging studies]
CL Item
Mri (MRI of the Brain with gadolinium)
CL Item
Mri (MRI of the Brain without gadolinium)
CL Item
Mri (MRI of Spine with gadolinium)
CL Item
Mri (MRI of Spine without gadolinium)
CL Item
Other, Specify (Other (specify))
Evaluation method, specify
Item
Specify
text
C25685 (NCI Thesaurus ValueDomain)
C2911685 (UMLS CUI-1)
C20989 (NCI Thesaurus ObjectClass)
C1521902 (UMLS CUI-2)
C16847 (NCI Thesaurus Property)
LesionAssessmentDate
Item
Date
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
Item Group
Tumor Location
SupratentorialInvolvementInd-3
Item
Were Supratentorial sites involved?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
C12923 (NCI Thesaurus ObjectClass)
C0441938 (UMLS 2011AA ObjectClass)
Item
Were there other Supratentorial sites?
text
CL111053 (NCI Metathesaurus Property)
CL.7
Code List
Were there other Supratentorial sites?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Other, Specify (Other, specify)
SupratentorialInvolvedSiteSpecify
Item
specify [other supratentorial sites] (If yes,)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
CL111053 (NCI Metathesaurus Property)
InfratentorialInvolvementInd-3
Item
Were Infratentorial sites involved?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
CL211504 (NCI Metathesaurus ObjectClass)
Item
check all Infratentorial sites involved on T1 post gadolinium MRI (If yes,)
text
CL.9
Code List
check all Infratentorial sites involved on T1 post gadolinium MRI (If yes,)
CL Item
Midbrain (Midbrain)
C0025462 (NCI Metathesaurus)
CL Item
Pons (Pons)
C0032639 (NCI Metathesaurus)
CL Item
Medulla (Medulla)
CL Item
Dorsal Exophytic Brainstem (Dorsal exophytic brainstem)
CL Item
Cerebellar Penducle (Cerebellar penducle)
CL Item
Cerebellar Hemisphere (Cerebellar hemisphere)
C0228465 (NCI Metathesaurus)
CL Item
Cerebellar Vermis (Cerebellar vermis)
CL Item
Fourth Ventricle (Fourth ventricle)
C12828 (NCI Thesaurus)
C0149556 (UMLS 2011AA)
CL Item
Cistema Magna (Cistema magna)
CL Item
Infratentorial Leptomeninges (Infratentorial Leptomeninges)
CL Item
Other, Specify (Other, specify)
Item
Were there other Infratentorial sites?
text
CL111053 (NCI Metathesaurus Property)
CL.10
Code List
Were there other Infratentorial sites?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Other, Specify (Other, specify)
InfratentorialInvolvedSiteSpecify
Item
specify [other infratentorial sites] (If yes,)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
CL111053 (NCI Metathesaurus Property)
SpinalCordInvolvementInd-3
Item
Was Spinal Cord involved at diagnosis?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
Item
Were there other Spinal Chord sites?
text
CL111053 (NCI Metathesaurus Property)
CL.13
Code List
Were there other Spinal Chord sites?
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Other, Specify (Other, specify)
SpinalCordInvolvedSiteSpecify
Item
specify [other spinal cord sites] (If yes,)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
CL111053 (NCI Metathesaurus Property)
DuraInvolvementInd-3
Item
Was Dura involved?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
Item
indicate type of involvement [dura] (If yes,)
text
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
CL.15
Code List
indicate type of involvement [dura] (If yes,)
CL Item
Nodular (Nodular)
CL Item
Diffuse (Diffuse)
C14175 (NCI Thesaurus)
C0205219 (UMLS 2011AA)
Item
Was CSF cytological evaluation of lumbar fluid positive?
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C12692 (NCI Thesaurus ObjectClass)
C0007806 (UMLS 2011AA ObjectClass)
C25548 (NCI Thesaurus Property)
C1314939 (UMLS 2011AA Property)
CL.16
Code List
Was CSF cytological evaluation of lumbar fluid positive?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Not Evaluated (Not evaluated)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
OtherSiteInvolvedInd-3
Item
Were there other sites involved?
boolean
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25547 (NCI Thesaurus Property)
CL111053 (NCI Metathesaurus ObjectClass)
DiseaseInvolvedSiteSpecify
Item
specify [other sites involved] (If yes,)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
Item Group
Primary Disease
Item
What is the primary disease site?
text
C13717 (NCI Thesaurus ValueDomain)
C1515974 (UMLS 2011AA ValueDomain)
C3824 (NCI Thesaurus ObjectClass)
C0221198 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C12439 (NCI Thesaurus ObjectClass-2)
C0006104 (UMLS 2011AA ObjectClass-2)
CL.18
Code List
What is the primary disease site?
CL Item
Frontal Lobe (Frontal lobe)
C12352 (NCI Thesaurus)
C0016733 (UMLS 2011AA)
CL Item
Parietal Lobe (Parietal lobe)
C12354 (NCI Thesaurus)
C0030560 (UMLS 2011AA)
CL Item
Temporal Lobe (Temporal lobe)
C12353 (NCI Thesaurus)
C0039485 (UMLS 2011AA)
CL Item
Occipital Lobe (Occipital lobe)
C12355 (NCI Thesaurus)
C0028785 (UMLS 2011AA)
CL Item
Basal Ganglia (Basal ganglia-thalamus)
C12447 (NCI Thesaurus)
C0004781 (UMLS 2011AA)
CL Item
Hypothalamus (Hypothalamus-optic chiasm)
C12458 (NCI Thesaurus)
C0020663 (UMLS 2011AA)
CL Item
Optic Nerve (Optic nerve)
C12761 (NCI Thesaurus)
C0029130 (UMLS 2011AA)
CL Item
Pineal (Pineal)
CL Item
Corpus Callosum (Corpus callosum)
C12446 (NCI Thesaurus)
C0010090 (UMLS 2011AA)
CL Item
Lateral Ventricle (Lateral ventricle)
C12834 (NCI Thesaurus)
C0152279 (UMLS 2011AA)
CL Item
Third Ventricle (Third ventricle)
C12827 (NCI Thesaurus)
C0149555 (UMLS 2011AA)
CL Item
Aqueduct Of Sylvius (Aquaduct of sylvius)
C32135 (NCI Thesaurus)
C0007769 (UMLS 2011AA)
CL Item
Supratentorial Leptomeninges (Supratentorial Leptomeninges)
CL Item
Midbrain (Midbrain)
C0025462 (NCI Metathesaurus)
CL Item
Pons (Pons)
C0032639 (NCI Metathesaurus)
CL Item
Medulla (Medulla)
CL Item
Dorsal Exophytic Brainstem (Dorsal exophytic brainstem)
CL Item
Cerebellar Peduncle (Cerebellar penducle)
C0228515 (NCI Metathesaurus)
CL Item
Cerebellar Hemisphere (Cerebellar hemisphere)
C0228465 (NCI Metathesaurus)
CL Item
Cerebellar Vermis (Cerebellar vermis)
CL Item
Fourth Ventricle (Fourth ventricle)
C12828 (NCI Thesaurus)
C0149556 (UMLS 2011AA)
CL Item
Cisterna Magna (Cistema magna)
C32324 (NCI Thesaurus)
C0008841 (UMLS 2011AA)
CL Item
Infratentorial Leptomeninges (Infratentorial Leptomeninges)
CL Item
Cervical (Cervical)
C12844 (NCI Thesaurus)
C0205064 (UMLS 2011AA)
CL Item
Thoracic (Thoracic Lumbosacral)
C13360 (NCI Thesaurus)
C0817096 (UMLS 2011AA)
CL Item
Conus (Conus)
C0598489 (NCI Metathesaurus)
CL Item
Cauda Equina (Cauda equina)
C12689 (NCI Thesaurus)
C0007458 (UMLS 2011AA)
CL Item
Spinal Cord (c1 And Below) (Spinal Cord Leptomeninges)
CL Item
Nodular (Nodular)
CL Item
Diffuse (Diffuse)
CL Item
Cerebellum (Cerebellum)
C12445 (NCI Thesaurus)
C0007765 (UMLS 2011AA)
CL Item
Brainstem (Brainstem)
CL Item
Optic Chiasm (Optic chiasm)
C0029126 (NCI Metathesaurus)
CL Item
Cavernous Sinus (Cavernous sinus)
C12690 (NCI Thesaurus)
C0007473 (UMLS 2011AA)
CL Item
Thalamus (Thalamus)
C12459 (NCI Thesaurus)
C0039729 (UMLS 2011AA)
CL Item
Leptomeningeal (Leptomeningeal)
CL Item
Lumbar (Lumbar)
CL Item
Other, Specify (Other, specify)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
Item Group
Ccrr Module For Acns0122 On Study Worksheet
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